Treatment Focus

Natalie specializes in treating multiple disorders. The descriptions of each condition provided below are based on the American Psychiatric Association’s DSM-5.

Obsessive-Compulsive Disorder (OCD)

Obsessions are recurrent or persistent thoughts, images, or urges that are intrusive in nature and cause marked distress and/or anxiety. Some people afflicted with OCD have feelings of disgust or guilt rather than anxiety. Compulsive behaviors are maladaptive repetitive behaviors completed for the purpose of reducing anxiety caused by obsessions. The behaviors are excessive and tend to require a substantial amount of time, resulting in impaired functioning at school, work, or social interactions. Some domains of obsessions include contamination, intrusive thoughts, scrupulosity, perfectionism, pathological doubt, symmetry or exactness, and superstitious fears. Common compulsive behaviors include excessive hand-washing, ritualized showering, replacing a bad thought with another to neutralize distress, praying, reassurance seeking, information seeking, repeating the same behaviors until they feel ‘just right,’ checking appliances, checking for signs of illness, checking whether mistakes were made, repeating routine activities, or feeling the need to ask, tell, or confess. Symptoms of OCD, when left untreated, can become debilitating to the extent that those afflicted can no longer engage in work, school, or complete activities of daily living.

Obsessive-Compulsive Disorder and related disorders affect many Americans. It is estimated that 1 in 100 adults suffer from OCD (IOCDF.org). According to the NIMH, anxiety disorders contribute to the second highest number of years of life lost due to a mental health disability. The emotional and financial burden of OCD and anxiety are substantial, and not just for those afflicted with the disorder. Family members and loved ones are commonly affected. Loved ones may struggle knowing how to approach the OCD or anxiety sufferer and can inadvertently escalate symptoms through accommodation. Functioning and relationships begin to suffer if the disorder goes untreated.

Natalie R. Noel specializes in treating OCD and related disorders, and anxiety disorders using the most current and evidenced-based treatments currently available for these conditions, Cognitive Behavior Therapy (CBT) and Exposure and Response Prevention (ERP).

Generalized Anxiety Disorder (GAD)

Those suffering from generalized anxiety disorder experience anxiety, fear, and distress commonly related to school or work performance, children’s safety, or finances. Excessive worry is a typical symptom of GAD that can cause changes in sleep pattern, restlessness, difficulty concentrating, irritability, and muscle tension. The anxiety and excessive worry can result in marked impairment in functioning related to school, work, and maintaining relationships.

Social Phobia

Significant fear or anxiety related to social situations where one could be exposed to the judgments of others. Social triggers include: meeting new people, having conversations, being watched or in front of other while eating or drinking, and performing in front of others. Those suffering from social phobia fear embarrassing themselves or offending others and typically avoid social triggers. Passive behaviors are also typical of those with social phobia. Overtime, social phobia can lead to isolation because avoidance become persistent and interferes with social, personal, and professional functioning.

Panic Disorder

Panic disorder consists of frequent and sudden panic attacks. Panic attack symptoms include rapid/pounding heart rate, chest pain, dizziness, fear of dying or losing control, feelings of nausea, faintness, shortness of breath, and sweating. The perceived consequences of panic attacks, such as a possible illness, embarrassment, or causing an injury or traumatic event, leads clients to avoid activities they used to easily engage in order to lower their chances of having a panic attack. Clients may be confused by their panic attacks because they are not followed by a specific trigger.

Phobias

Phobias are a type of anxiety disorder which cause intense and extreme fear of an object or situation, which may include insects, heights, group settings, injections, vomiting, blood, and more. Those with phobias will go to extreme lengths to avoid the feared stimuli. Phobias can become debilitating due to interferences in functioning related to school, work, or leisure.

Body Dysmorphic Disorder (BDD)

BDD is an embellished view of physical features perceived as flaws that can lead one to isolate, hide the features with clothing, or even result in extreme measures such as unnecessary surgery. The physical feature is viewed by the individual as ugly, deformed, inadequate, or abnormal, yet appears normal to others. With BDD, the physical feature associated with preoccupation cannot be connected to concerns of body fat or weight. Typical features that cause distress for those with BDD include: hair, nose, skin, muscularity, and symmetry of body parts. Common rituals associated with BDD include mirror checking, comparing oneself to others, asking people for reassurance regarding appearance, excessive exercising or grooming.

Post-Traumatic Stress Disorder (PTSD)

PTSD is caused by direct exposure to an actual or near death event, serious injury, sexual assault, or accident. Someone suffering from PTSD may be the victim of a trauma or could have witnessed a traumatic event. As a result, one may experience intrusive memories of the event, have startled responses, feel an increased alertness to possible threat, distressing dreams, flashbacks, and more. PTSD will interfere with one’s functioning, mood, and thoughts. Clients avoid triggering objects or situations that remind them of the traumatic event.

Trichotillomania (hair-pulling disorder)

Trichotillomania is recurrent pulling of the hair that can lead to hair loss. Despite ones’ attempts to refrain from pulling, they still find the behavior to be out of their control. Areas commonly picked are on the head, eye-brows, arms, and pubic region. Anxiety and distress are common since the behavior and hair loss result in isolation from others and avoidance of situation involving others such as school, work, or social events.

Excoriation (skin-picking)

Excoriation involves the repeated behavior of picking skin or scabs that can result in severe lesions and leaving one feeling like the behavior is out of their control. The disorder causes significant distress and hinders functionality.

Tourette’s and Tic Disorder

Tics are quick, unexpected, and persistent motor movement or vocalization. Tourette’s involves both motor and verbal tics. Tics may come and go, but must persist for at least a year to be determined as a Tic Disorder. Common tics include blinking, sniffing, coughing, grunting, throat clearing, head turning, shoulder shrugging, repeating words or sounds, arm twitching, and many more.

Major Depressive Disorder (MDD)

Persistent depressed mood and loss of interest of previously enjoyed activities are the main components of major depressive disorder. Clients feel sad, worthless, and hopeless throughout most of the day. Lack of motivation and fatigue are prevalent each day. Interruptions in sleep patterns and appetite are common. Clients frequently report difficulty with concentrating and making decisions. Suicidal or death ideations are also typical with MDD.